THE CHALLENGES IN THE NIGERIAN HEALTH SECTOR AND EFFORTS TOWARDS ACHIEVING UNIVERSAL HEALTH COVERAGE
BY GLORIA ESSIEN
On October 7, 2020, the Nigerian government rolled out a 10-year plan of achieving Universal Health Coverage.
The Universal Health Coverage entails providing effective access to health, including financial risk protection to at least essential healthcare for the poorest and the most vulnerable population in the society.
Universal Health Coverage (UHC) is key to achieving the world’s Sustainable Development Goals, SDG-3 which targets are on ending preventable deaths of new-borns and children under-5 years of age by 2030.
Nigeria is among the African nations that subscribes to achieving UHC by the year 2030.
The National Primary Health Care Development Agency (NPHCDA), is one of the agencies that is responsible for developing plans and policies to push Nigeria towards actualising its quest for achieving the UHC.
There is still so much to be done by the NPHCDA in achieving the set goals. In Nigeria today, about one hundred and forty-five women of childbearing age and two thousand five hundred children under five years of age die daily in the country as a result of lack of adequate facilities.
The country depends largely on foreign donors for health interventions on challenges such as Family Planning, Eradication of major diseases like HIV, Tuberculosis and Malaria.
This places Nigeria more than ever at risk as even the well-developed countries and organisations that contribute hugely to interventions such as the Global Funds, GAVI, Bill and Melinda Gates Foundation are crippled by the COVID-19 pandemic which affected over two hundred countries, infecting and killing millions of people across the globe.
The global economic losses from the COVID-19 pandemic has tremendously set back the progress of the 2030 Sustainable Development Goals agenda.
Some of the factors responsible for the health challenges in Nigeria include; poor funding, lack of research in health-related issues, lack of proper enumeration of health workers, lack of commodities, high cost of health care, incessant doctors’ strike, exodus of health workers weak funding models and systematic bottlenecks amongst others.
Similarly, the three tiers of government in the country pose a serious threat to cascading policies and interventions that will drive UHC, as the Nigerian constitution is silent on who is directly responsible for health in the three tiers of government.
To achieve UHC, government’s agencies at the Federal level must work in synergy with their State counterparts as it was in the 2015 NHIS conceptual framework for decentralization of Primary Health Care delivery in the country.
The National Health Insurance Scheme (NHIS) also unveiled and began the implementation of the Health Insurance Under One Roof a concept which is key to fast-tracking Nigeria’s pursuit for Universal Health Coverage.
The NHIS is facing difficulties in expanding coverage due to non-mandatory participation as provided in the extant law and the recognition of the need to cover the large informal sector in order to “Leave no-one behind,” with the idea of decentralizing health insurance to the sub-national level.
For the attainment of UHC in Nigeria within President Muhammadu Buhari’s Health Sector Next Level Agenda, there should be an effective framework for coordination, integration and harmonization of efforts of all stakeholders in the health sector of the country.